The new label "incorporates the latest in nutrition science as more has been learned about the connection between what we eat and the development of serious chronic diseases impacting millions of Americans," including obesity and heart disease, FDA commissioner Margaret Hamburg, MD, said in a statement.

The American Heart Association cheered the proposed changes in a statement from CEO Nancy Brown.

"Eating healthy is a habit all Americans need to have, and the FDA's proposed new nutrition labels will help put that goal within reach," she said. "By arming consumers with more knowledge about nutritional content, calories, and serving sizes, this new labeling information takes an important step toward improving the health of all Americans."

She noted, however, that the AHA would like to see the daily value for sodium lowered even further from the 2,300 mg included in the FDA's new labels.

"There is strong scientific evidence that indicates lowering sodium can result in significant reductions in blood pressure," Brown said. "Consequently, the association will continue to recommend sodium intake be limited to 1,500 mg a day."

"Hence, the most important change is to increase the prominence of calorie content and increase portion sizes to reflect current intakes," she said in an email. "The second most important change is to list added sugar. The Dietary Guidelines advise Americans to reduce added sugar intake; however, at this time there is no way to determine the added sugar content, for example, of flavored yogurt. Now that will be possible."

"The new food label is a big step forward. It emphasizes calories, added sugars, and updated portion sizes," she said in an email to MedPage Today. "I never thought the FDA would have the courage to do this. It will not be comfortable for makers of packaged foods of low nutritional quality."

One draft image of the guideline shows that the number of calories will be the focal point, printed in big, bold type. The number of servings per container also stands out in order to reinforce the message that calorie counts go up with the number of servings consumed.

Also in that draft image, the "added sugars" section is nested under the "sugars" category within the total carbohydrate class.

All fat types will still be listed, but the FDA wants to nix "calories from fat" because research has shown that fat type is more important than the amount.

While vitamin D and potassium will still be labeled, companies will no longer have to declare vitamin A and C contents, although they can do so voluntarily, the agency said.

Daily values for sodium, dietary fiber, and vitamin D will also get a revision.

Hamburg said the changes reflect research linking diet and chronic disease; for example, connecting the dots from obesity to diabetes and heart disease.

The last time nutrition labels were altered was in 2006 when the agency required trans fats to be added under total fats.

Jaclyn London, MS, RD, of Mount Sinai Hospital in New York City, said there's been "general confusion and ambiguity regarding both portion size and healthful food choices" with the outdated labels.

"The FDA's update, which will place a greater emphasis on total calories rather than specific food claims, has the intention of being more straightforward and realistic by showing consumers how much they're actually eating, instead of what they should be eating," London said.

She cautioned, however, that without "fundamental nutrition education and basic understanding of what constitutes a 'wholesome food,' we may continue to face difficulty inspiring behavior change in the long term."

"Although this is a significant step in consumer education, efforts to inform individuals on general healthy diet and the importance of consuming fresh foods will remain an ongoing challenge as we move forward with this exciting new development," London added.

Indeed, several groups favor making basic dietary guidelines easier to understand, with an emphasis on foods instead of nutrients. Last week, those groups lauded updated guidelines from Brazil that do focus on foods and other more general recommendations on eating that are easily understood.

Lichtenstein said that the effect of the FDA's proposed changes on public health "will depend on whether the revamped Nutrient Facts label is actually used by those consumers who would benefit from improving their diet and don't currently use the labels."

"By increasing the prominence of the calorie content, aligning portion sizes with current intakes, adding information most important to public health, and deleting extraneous information, the intent is that the label will be more user friendly," she said. "Critical is to conduct extensive consumer testing to confirm that the changes actually resonate with those individuals who need it the most."

FDA noted that certain meat, poultry, and processed egg products aren't affected by the changes because they're regulated by U.S. Department of Agriculture food inspections.

The agency will take public comments on the proposed label changes for the next 90 days.

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